CONDENSED INDOLE DERIVATIVES AS 5-HT4-RECEPTOR ANTAGONISTS

Abstract: A compound of formula (IA) or a pharmaceutically acceptable salt thereof, wherein X is O, S, SO, SO2, CH2, CH or NR wherein R is hydrogen or C1-6 alkyl; A is a saturated or unsaturated polymethylene chain of 2-4 carbon atoms; R1 and R2 are hydrogen or C1-6 alkyl; R3 is hydrogen, halo, C1-6 alkyl, amino, nitro or C1-6 alkyl; R4 is hydrogen, halo, C1-6 alkyl or C1-6 alkoxy; Y is O or NH; Z is of sub-formula (a), wherein N<1> is 1, 2, 3 or 4; q is 0, 1, 2 or 3; R5 is 3-phenoxypropyl; or a compound of formula (IA) wherein the CO-Y linkage is replaced by a heterocyclic bioisostere; having 5-HT4 receptor antagonist activity.

Description: CONDENSED INDOLE DERIVATIVES AS 5 HT4-RECEPTOR ANTAGONISTS This invention relates to novel compounds having pharmacological activity, to a process for their preparation and to their use as pharmaceuticals. EP-A-429984 (Nisshin Flour Milling Co., Ltd.) describes indole derivatives having 5-HT3 receptor antagonist activity. European Journal of Pharmacology 146 (1988), 187-188, and Naunyn-Schmiedeberg's Arch. Pharmacol. (1989)340:403410, describe a non classical 5-hydroxytryptamine receptor, now designated the 5-HT4 receptor, and that ICS 205-930, which is also a 5-HT3 receptor antagonist, acts as an antagonist at this receptor. WO 91/16045 (SmithKline and French Laboratories Limited) describes the use of cardiac 5-HT4 receptor antagonists in the treatment of atrial arrhythmias and stroke. EP-A-501322 (Glaxo Group Limited) describes indole derivatives having 5-HT4 antagonist activity. WO 94/01-095 (SmithKline Beecham plc) describes compounds having 5-HT4 receptor antagonist activity of formula (I), or a pharmaceutically acceptable salt thereof: EMI1.1 wherein X is O, S, SO, S02, CH2, CH or NR wherein R is hydrogen or C16 alkyl; A is a saturated or unsaturated polymethylene chain of 2-4 carbon atoms; R1 and R2 are hydrogen or C 1 -6 alkyl; R3 is hydrogen, halo, C16 alkyl, amino, nitro or C16 alkyl; R4 is hydrogen, halo, C1.6 alkyl or C14 alkoxy; YisOorNH; Z is of sub-formula (a), (b) or (c): : EMI2.1 wherein n1 is 1,2,3 or 4;nê is 0, 1,2,3 or 4;n is 2,3,4or 5; q 1,2or3;pis0, 1 or2;mis0, 1 or2; R5 is hydrogen, Cl l2 alkyl, aralkyl or R5 is (CH2)Z-R10 wherein z is 2 or 3 and R10 is selected from cyano, hydroxyl, C1-6 alkoxy, phenoxy, C(O)C1.6 alkyl, COC6Hst -CONR11R12, NR11COR12, S02NR11R12 orNR11SO2R12 wherein R11 and R12 are hydrogen or C1 6 alkyl; and R6, R7 and R8 are independently hydrogen or C1 6 alkyl; and Rg is hydrogen or C1.10 alkyl; or a compound of formula (I) wherein the CO-Y linkage is replaced by a heterocyclic bioisostere; having 5-HT4 receptor antagonist activity. Examples of alkyl or alkyl containing groups include C1, C2, C3, C4, C5, C6, C7, C8, Cg, C10, C11 or C12 branched, straight chained or cyclic alkyl, as appropriate. C1 4 alkyl groups include methyl, ethyl, n- and iso-propyl, n-, iso-, secand tert-butyl. Cyclic alkyl includes cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl and cyclooctyl. Aryl includes phenyl and naphthyl optionally substituted by one or more substituents selected from halo, C1 6 alkyl and C1-6 alkoxy. Halo includes fluoro, chloro, bromo and iodo. A suitable bioisostere for the amide or ester linkage containing Y in formula (I), is of formula (d): EMI3.1 wherein the dotted circle represents one or two double bonds in any position in the 5membered ring; H, Jand I independently represent oxygen, sulphur, nitrogen or carbon, provided that at least one of H, J and I is other than carbon; U represents nitrogen or carbon. Suitable examples of (d) are as described for X, Y and Z in EP-A-328200 (Merck Sharp & Dohme Ltd.), such as an oxadiazole moiety. X is often 0. Values for A include -CH2-(CH2)r-CH2- wherein r is 0, 1 or 2; -CH2-CH=CH-; -C(CH3)=CH- or when X is CH or N, A may be -(CHZh-CH= or -CH=CH-CH=. Other examples of A are as described in the examples hereinafter. R1 and R2 are often hydrogen or R1 and R2 are gem-dimethyl. rips soften 1. R3 is preferably hydrogen. R4 is preferably hydrogen or halo, such as fluoro. YispreferablyOorNH. When Z is of sub-formula (a), nl is preferably 2, 3 or 4 when the azacycle is attached at the nitrogen atom and nl is preferably 1 when the azacycle is attached at a carbon atom, such as the 4-position when q is 2. When Z is of sub-formula (b), n2 is preferably such that the number of carbon atoms between the ester or amide linkage is from 2 to 4 carbon atoms. Suitablevaluesforpandmincludep=m= l;p=0,m=l,p=l,m=2, p = 2, m = 1. When Z is of sub-formula (c), n3 is preferably 2, 3 or 4. R8 and Rg are preferably both alkyl, especially one of R8 and Rg is C4 or larger alkyl. Specific values of Z of particular interest are as follows: EMI4.1 Compounds within formula (I) with include those with side chains (i), (ii), (iii), (iv), (v), (vi) or (vii). In a further aspect, the piperidine ring in (i), (ii) or (iii) may be replaced by pyrrolidinyl or azetidinyl, and/or the N-substituent in (i) or (ii) may be replaced by C3 or larger alkyl or optionally substituted benzyl. In an alternative aspect, the N-substituent in formula (i) or (ii) may be replaced by (CH2)nR4 as defined in formula (I) and in relation to the specific examples of EP-A-501322. The pharmaceutically acceptable salts of the compounds of the formula (I) include acid addition salts with conventional acids such as hydrochloric, hydrobromic, boric, phosphoric, sulphuric acids and pharmaceutically acceptable organic acids such as acetic, tartaric, maleic, citric, succinic, benzoic, ascorbic, methanesulphonic, a-keto glutaric, a-glycerophosphoric, and glucose-l-phosphoric acids. Examples of pharmaceutically acceptable salts include quaternary derivatives of the compounds of formula (I) such as the compounds quaternised by compounds RX-T wherein Rx is C1 6 alkyl, phenyl-C1.6 alkyl or Cos 7 cycloalkyl, and T is a radical corresponding to an anion of an acid. Suitable examples of Rx include methyl, ethyl and n- and iso-propyl; and benzyl and phenethyl. Suitable examples of T include halide such as chloride, bromide and iodide. Examples of pharmaceutically acceptable salts also include internal salts such as N-oxides. The compounds of the formula (I), their pharmaceutically acceptable salts, (including quaternary derivatives and N--oxides) may also form pharmaceutically acceptable solvates, such as hydrates, which are included wherever a compound of formula (t) or a salt thereof is herein referred to. It will also be realised that the (CH2)n2 moiety in compounds of formula (I) wherein Z is (b), may adopt an a or ss or configuration with respect to the fused azabicyclic moiety. The compounds of formula (I) may be prepared by conventional coupling of the indole moiety with Z. Suitable methods are as referred to in WO 94/01095, the subject matter of which is incorporated herein by reference. Examples of Compounds of Formula (I) R1 R2 r R3 R4 X Y Z El H H 1 H H O O (i) E2 H H 1 H H O O (vi) E3 H H 1 H H O NH (i) E4 H H 1 H H O O (iii) ES H H 1 H H O NH (iii) E6 H H O H H O 0 (i) E7 (CH3)2 -1 H H 0 O (i) Es H H 1 H H S O (i) E9 H H 2 H H O O (i) E10 H H 1 H H CH2 O (i) E11 H H O H H CH2 O (i) E12 H H 2 H H CH2 O (i) E13 H H O H H CH2 NH (i) E14 H H O H H O NH (i) E15 H H 1 H H O O Bzppm E16 H H 1 H H SO O (i) Examples of Compounds of Formula (I) (cont.) R1 R2 r R3 R4 X Y Z E17 H H A H H CH O (i) E18 H H r H H CH O (i) E19 H H 1 H H S NH (i) E20 H H 1 H H O NH Bzppm E21 H H 1 H H O NH ppm E22 H H 1 H H O NH nC6H13ppm E23 H H 1 H H O NH (ii) E24 H H 1 H H O NH Etppm E25 H H 1 H H O NH MeS02aEtppm E26 H H 1 H H O NH (vi) E27 H H 1 8-F H O O (i) E28 H H 1 8-F H O NH (i) E29 H H 1 H H NMe O (i) Examples of Compounds of Formula (I) (cont.) R1 R2 r R3 R4 X Y Z E30 -- # - H H S O (i) E31 H H 0 H H S O (i) E32 -- # - H H S O (i) E33 - A - H H N O (i) E34 H H 0 H H S NH (i) E35 - # -- H H S NH (i) -E36 H H 1 H H NH O (i) E37 H H 0 H H O O (vi) E38 H H 2 H H O NH (i) E39 H H r H H N O (i) E40 H H 0 H H S O (vi) Examples of Compounds of Formula (I) (cont.) R1 R2 r R3 R4 X Y Z E41 H H O H H S NH (vi) E42 -- ss -- H H S O (vi) E43 . # -- H H S NH (vi) E44 H H 1 H H S O (vi) E45 - # -- H H NH NH (i) E46 H H 1 H H N NH (i) A - AR1R2 is -(CH2)2-CH- Bz - benzyl r - AR1R2 is-CH=CH-CH= ppm - 4-piperidylmethyl It - AR1R2 is -C(CH3)=CH- aEt- aminoethyl # - AR1R2 is -CH=CH- A- AR1R2 is C(CH3)=CH-C(CH3)= The present invention provides a compound of formula (I) wherein R5 is 3-phenoxypropyl, referred to herein as a compound of formula (it), in particular a compound of formula analogous to E3 above wherein the n-butyl R5 substituent is replaced by phenoxypropyl. The compounds of the present invention are 5-HT4 receptor antagonists and it is thus believed may generally be used in the treatment or prophylaxis of gastrointestinal disorders, cardiovascular disorders and CNS disorders. They are of potential interest in the treatment of irritable bowel syndrome (IBS), in particular the diarrhoea aspects of IBS, i.e., these compounds block the ability of 5-HT to stimulate gut motility via activation of enteric neurones. In animal models of IBS, this can be conveniently measured as a reduction of the rate of defaecation. They are also of potential use in the treatment of urinary incontinence which is often associated with IBS. They may also be of potential use in other gastrointestinal disorders, such as those associated with upper gut motility, and as antiemetics. In particular, they are of potential use in the treatment of the nausea and gastric symptoms of gastrooesophageal reflux disease and dyspepsia Antiemetic activity is determined in known animal models of cytotoxic-agent/radiation induced emesis. Specific cardiac 5-HT4 receptor antagonists which prevent atrial fibrillation and other atrial arrhythmias associated with 5-HT, would also be expected to reduce occurrence of stroke (see J. Kaumann 1990, Naumyn-Schmiedeberg's Arch. Pharmacol. 342, 618-622, for appropriate animal test method). Anxiolytlc activity is likely to be effected via the hippocampus (Dumuis et al 1988, Mol Pharmacol, 34,880-887). Activity can be demonstrated in standard animal models, the social interaction test and the X-maze test. Migraine sufferers often undergo situations of anxiety and emotional stress that precede the appearance of headache (Sachs, 1985, Migraine, Pan Books, London). It has also been observed that during and within 48 hours of a migraine attack, cyclic AMP levels are considerably increased in the cerebrospinal fluid (Welch et al., 1976, Headache 16, 160-167). It is believed that a migraine, including the prodomal phase and the associated increased levels of cyclic AMP are related to stimulation of 5-HT4 receptors, and hence that administration of a 5-HT4 antagonist is of potential benefit in relieving a migraine attack. Other CNS disorders of interest include schizophrenia, Parkinson's disease and Huntingdon's chorea. The invention also provides a pharmaceutical composition comprising a compound of formula (IA), or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier. Such compositions are prepared by admixture and are usually adapted for enteral such as oral., nasal or rectal, or parenteral administration, and as such may be in the form of tablets, capsules, oral liquid preparations, powders, granules, lozenges, reconstitutable powders, nasal sprays, suppositories, injectable and infusable solutions or suspensions. Orally administrable compositions are preferred, since they are more convenient for general use. Tablets and capsules for oral administration are usually presented in a unit dose, and contain conventional excipients such as bindingragents, fillers, diluents, tabletting agents, lubricants, disintegrants, colourants, flavourings, and wetting agents. The tablets may be coated according to well known methods in the art, for example with an enteric coating. Suitable fillers for use include cellulose, mannitol, lactose and other similar agents. Suitable disintegrants include starch, polyvinylpolypyrrolidone and starch derivatives such as sodium starch glycollate. Suitable lubricants include, for example, magnesium stearate. Suitable pharmaceutically acceptable wetting agents include sodium lauryl sulphate. Oral liquid preparations may be in the form of, for example, aqueous or oily suspensions, solutions, emulsions, syrups, or elixirs, or may be presented as a dry product for reconstitution with water or other suitable vehicle before use. Such liquid preparations may contain conventional additives such as suspending agents, for example sorbitol, syrup, methyl cellulose, gelatin, hydroxyethylcellulose, carboxymethylcellulose, aluminium stearate gel or hydrogenated edible-fats, emulsifying agents, for example lecithin, sorbitan monooleate, or acacia; non-aqueous vehicles (which may include edible-oils), for example, almond oil, fractionated coconut oil, oily esters such as esters of glycerine, propylene glycol, or ethyl alcohol; preservatives, for example methyl or propyl p-hydroxybenzoate or sorbic acid, and if desired conventional flavouring or colouring agents. Oral liquid preparations are usually in the form of aqueous or oily suspensions, solutions, emulsions, syrups, or elixirsor are presented as a dry product for reconstitution with water or other suitable vehicle before use. Such liquid preparations may contain conventional additives such as suspending agents, emulsifying agents, non-aqueous vehicles (which may include edible oils), preservatives, and flavouring or colouring agents. The oral compositions may be prepared by conventional methods of blending, filling or tabletting. Repeated blending operations may be used to distribute the active agent throughout those compositions employing large quantities of fillers. Such operations are, of course, conventional in the arL For parenteral administration, fluid unit dose forms are prepared containing a compound of the present invention and a sterile vehicle. The compound, depending on the vehicle and the concentration, can be either suspended or dissolved. Parenteral solutions are normally prepared by dissolving the compound in a vehicle and filter sterilising before filling into a suitable vial or ampoule and sealing. Advantageously, adjuvants such as a local anaesthetic, preservatives and buffering agents are also dissolved in the vehicle. To enhance the stability, the composition can be frozen after filling into the vial and the water removed under vacuum. Parenteral suspensions are prepared in substantially the same manner except that the compound is suspended in the vehicle instead of being dissolved and sterilised by exposure of ethylene oxide before suspending in the sterile vehicle. Advantageously, a surfactant or wetting agent is included in the composition to facilitate uniform distribution of the compound of the invention. The invention further provides a method of treatment or prophylaxis of irritable bowel syndrome, dyspepsia, atrial arrhythmias and stroke, anxiety and/or migraine in mammals, such as humans, which comprises the administration of an effective amount of a compound of the formula (IA) or a pharmaceutically acceptable salt thereof. An amount effective to treat the disorders hereinbefore described depends on the relative efficacies of the compounds of the invention, the nature and severity of the disorder being treated and the weight of the mammal. However, a unit dose for a 70kg adult will normally contain 0.05 to 1000mg for example 0.5 to 500mg, of the compound of the invention. Unit doses may be administered once or more than once a day, for example, 2,3 or 4 times a day, more usually 1 to 3 times a day, that is in the range of approximately 0.0001 to 50mg/kg/day, more usually 0.0002 to 2-5 mglkglday. No adverse toxicological effects are indicated within the aforementioned dosage ranges. The invention also provides a compound of formula (IA) or a pharmaceutically acceptable salt thereof for use as an active therapeutic substance, in particular for use in the treatment of irritable bowel syndrome, gastro-oesophageal reflux disease, dyspepsia, atrial arrhythmias and stroke, anxiety and/or migraine. The following Example illustrates the preparation of compounds of formula (lea), the following Descriptions relate to the preparation of intermediates. Example N*[(1-(OPhenoxypropylf4-piperidinyl)methyl] 3,4-dihydro-2H [1,3]oxazino[3,2-a]indole-l0-carboxamide [X = O, A = (CH2)3, (R1, R2, R3, R4 = H; Y = NH, Z = 4-piperidinylmethyl, R5 = 3-phenoxypropyl] A stirred solution of N-(4-piperidinylmethyl) 3,4-dihydro-2H [1,3]oxazino[3,2-a]indole-10-carboxamide (D2) (250mg, 0.80 mmole) and triethylamine (0.25 ml, 1.8 mmole) in a mixture of acetonitrile (15 ml) and N,Ndimethylformamide (lOml) was treated with 3-phenoxypropyl bromide (0.13 ml, 0.88 mmole) and the solution heated under reflux for 48h. The mixture was allowed to cool, then concentrated in vacuo and the residue dissolved in ethyl acetate (25 ml) and washed with water (20 ml). The organic solution was dried (MgSO4), concentrated in vacuo and the residue purified by flash chromatography on silica gel eluting with 0 20% methanollethyl acetate to afford the title compound as a pale pink solid after trituation with ether (44mg) mp 120-1260C. 1H NMR (CDC13) 8:-8.30(d,1H), 7.07-7.37(m,5H), 6.96(t,1H), 6.88(d,2H), 6.64(t,1H)+ 4.57(t,2H), 4. 13(t,2H), 4.30(t,2H), 3.22-3.43(m,4H), 2.78-3.00(m,2H), 2.13-2.57(m,6H), 1.592.03(m,5H). Description 1 (l-Benzyl-4-piperldinyl)methylamlne(D 1) A stirred solution of isonipecotamide (30. 1g, 0.23 mole) and benzyl bromide (27.9 ml, 0.23 mole) in ethanol (250 ml) was treated with anhydrous potassium carbonate (64.9g, 0.47 mole) and heated under reflux for 3h. The mixture was allowed to cool, then filtered and the filtrate concentrated under vacuum. The residual oil was dissolved in chloroform (200 ml) and washed with water (1 x 150 ml), then dried (Na2S04) and concentrated under vacuum to leave a yellow solid (41.0g). This solid was mixed thoroughly with phosphorus pentoxide (38.3g, 0.27 mole) and the mixture heated at 1800C under nitrogen for 2.5h with gentle stirring. The reaction mixture was allowed to cool, then treated with water (300 ml). When the solid mass had dissolved, the solution was basified by addition of solid K2C03 and extracted with ethyl acetate (2x250 ml). The combined extracts were dried (Na2S04) and concentrated in vacuo to leave a brown oil (35.3g). This was dissolved in dry ether (250 ml) and added dropwise over 30 minutes to a stirred suspension of lithium aluminium hydride (10.1g, 0.26 mole) in ether (150ml) at OOC under nitrogen. When addition was complete, the mixture was allowed to warm up to room temperature and was stirred for 1.5h. It was re-cooled to OOC and treated cautiously with water (lOml), 10% NaOH solution (15 ml) and water again (25ml). The mixture was filtered through kieselguhr and the filtrate concentrated in vacuo to leave a brown oil, which was distilled underEvacuum to afford the title compound as a colourless oil after distillation (27.8g, 67%) bp 1060C at 0.25 mmHg. 1H NMR (CDCl3) 5: 7.20-7.37(m,5H), 3.48(s,2H), 2.85-2.95(m,2H), 2.55(d,2H), 1.87-2.00(m,2H), 1.60-1.75(m,2H), 1.10-1.40(m,5H). Description 2 a) N-[(l-Benzyl-4piperidinyl)methyl]indole-3-carboxamide To a stirred solution of indole-3-carboxylic acid (15g, 0.093mole) in dichloromethane (250 ml) under nitrogen was added oxalyl chloride (8.7 ml, 0.10 mole) and dry dimethylformamide (6 drops). After 2 hours, the solvent was evaporated under reduced pressure. The residual acid chloride (0.093 mole);wasdissolved in dichloromethane (100 ml) and added dropwise to a stirredsolution of N-(l-benzyl-4piperidinyl)methylamine (D1, 16.4g, 0.093 mole) and triethylamine (15.5 ml, 0.11 mole) in dichloromethane (150 ml) at 50C. After stirring at ambient temperature overnight, the reaction mixture was washed with 10% N a2C O3 and the organic phase was dried (Na2SO4). The solvent was evaporated under reduced pressure and the residual solid recrystallised from ethyl acetate to afford the title compound as a white solid (17.5g, 60%). 1H NMR (CDC13) b: 9.90(s,1H), 7.85-7.95(m,1H), 7.64(d,1H), 7.15-7.43(m,8H), 6.17(t,lH), 3.48(s,2H), 3.37(t,2H), 2.83-2.98(m,2H), 1.87-2.08(m,2H), 1.54-1.82(m,3H), 1.231.50(m,2H). b) N-[(1-Benzyl-4-piperidinyl)methyl] 3,4-dihydro-2H 11,3]oxazinol3,2-a]indole-10-carboxamide A stirred suspension of N-[(l-benzyl-Spiperidinyl)methyl] indole-3-carboxamide (17.5g, 0.050 mole) in chloroform (250 ml) was treated with 3-bromo-l-propanol (10.1 ml, 0.11 mole) and N-chlorosuccinimide (8.7g, 0.065 mole) at room temperature and a clear solution was obtained in 15 minutes. After lh the reaction mixture darkened in colour from pale yellow to orange and temperature rose to 380C. After a further 1 h the reaction mixture was treated with 10% NaHC03 solution and the chloroform layer separated, dried (Na2S04) and concentrated in vacuo to leave a yellow oil, which was chromatographed on silica gel eluting with 3% methanoUchloroform. The 2-(3-bromopropoxy)indole intermediate was dissolved in acetone (400 ml), treated with anhydrous potassium carbonate (1 lg, 0.08 mole) and stirred at room temperature for 20h. The reaction mixture was concentrated in vacuo and the residue treated with water (200 ml) and extracted with chloroform (2 x 250 ml). The combined extracts were dried (Na2S04), concentrated in vacuo and the residue chromatographed on silica gel eluting with 5% methanollchioroform to afford the title compound as a pale yellow oil (3.lg, 15%). This was converted to its oxalate salt and crystallised from acetone as a white solid mp 169-1700C. Free base:- 1H NMR (CDCl3) 5: 8.32(d,lH), 7.05-7.38(m,8H), 6.53(t,lH), 4.50(t,2H), 4.08(t,2H), 3.48(s,2H), 3.31 (t,2H), 2.83-2.97(m,2H), 2.27-2.41(m,2H), 1.54-2.06(m,5H), 1.25-1.45(m,2H). c) N-(4-Piperidinylmethyl) 3,4-dihydro-2H-[1,3]oxazino[3,2-a]indole-10- carboxamide A stirred suspension of N-[(l-benzyl-4-piperidinyl)methyl] 3,4-dihydro-2H [1,3]oxazino[3,2-a]indole-10-carboxamide oxalate salt (2.25g, 0.0046 mole) in ethanol (100 ml) and glacial acetic acid (4 ml) was hydrogenated over 10% Pd-C (0.8g) at atmospheric pressure and 450C for 18h. The mixture was filtered and the filtrate concentrated in vacuo. The majority of the product was in the solid which had been filtered off. This material was shaken with concentrated potassium carbonate solution (50 ml) and chloroform (50 ml) together with the residue from-the filtrate. The mixture was filtered, the chloroform layer separated and dried (Na2S04), then concentrated in vacuo to afford the title compound (D2) as a white solid (1.52g, 100%). This was recrystallised from chloroform/60-80 petrol mp 139-1410C. 1H NMR (CDCl3) b: 8.32(d,lH), 7.03-7.30(m,3H), 6.53(t,1H), 4.48(t,2H), 4.05(t,2H), 3.30(t,2H), 3.023.15(m,2H), 2.52-2.70(m,2H), 2.27-2.40(m,2H), 1.65-1.90(m,4H), 1.10-1.30(m,2H). 5-HT4 RECEPTOR ANTAGONIST ACTIVITY 1) Guinea pig colon Male guinea-pigs, weighing 250-400g are used. Longitudinal muscle-myenteric plexus preparations, approximately 3cm long, are obtained from the distal colon region. These are suspended under a 0.5g load in isolated tissue baths containing Krebs solution bubbled with 5% CO2 in 2 and maintained at 370C. In all experiments, the Krebs solution also contains methiothepin 10-7M and granisetron 10-6M to block effects at 5-HT1, 5-HT2 and 5-HT3 receptors. After construction of a simple concentration-response curve with 5-HT, using 30s contact times and a 15min dosing cycle, a concentration of 5-HT is selected so as to obtain a contraction of the muscle approximately 40-708 maximum(10-9M approx). The tissue is then alternately dosed every 15min with this concentration of 5-HT and then with an approximately equi-effective concentration of the nicotine receptor stimulant, dimethylphenylpiperazinium (DMPP). After obtaining consistent responses to both 5-HT and DMPP, increasing concentrations of a putative 5-HT4 receptor antagonist are then added to the bathing solution. The effects of this compound are then determined as a percentage reduction of the contractions evoked by 5-HT or by DMPP. From this data, pICso values are determined, being defined as the -log concentration of antagonist which reduces the contraction by 50%. A compound which reduces the response to 5-HT but not to DMPP is believed to act as a 5-HT4 receptor antagonist. The compound had a pICso of 9.65 + 0.20 (n = 4). 2) Rat oesophagus Rat oesophageal tunica muscularis mucosae is set up according to Baxter et. al. Naunyn-Schmiedeberg's Arch. Pharmacol., 343,439446 (1991). The inner smooth muscle tube of the muscularis mucosae is isolated and mounted for isometric tension recording in oxygenated (95% 0215% C02) Tyrodes solution at 37"C. All experiments are performed in pargyline pre-treated preparations (100pM for 15 min followed by washout) and in the presence of cocaine (30pom). Relaxant responses to 5-HT are obtained after pre-contracting the oesophagus tissue with carbachol (3pM).

Claims: Claims 1. A compound of formula (IA) or a pharmaceutically acceptable salt thereof: EMI17.1 wherein X is 0, S, SO, SO2, CH2, CH or NR wherein R is hydrogen or C1-6 alkyl; A is a saturated or unsaturated polymethylene chain of 2-4 carbon atoms; R1 and R2-are hydrogen or-C 1.6 alkyl; R3 is hydrogen, halo, C1 6 alkyl, amino, nitro or C1 6 alkyl; R4 is hydrogen, halo, C1 6 alkyl or C1 6 alkoxy; YisOorNH; Z is of sub-formula (a): EMI17.2 wherein no is 1, 2, 3 or 4; qisO, 1,2Or3; R5 is-3-phenoxypropyl; or a compound of formula (IA) wherein the CO-Y linkage is replaced by a heterocyclic bioisostere; having 5-HT4 receptor antagonist activity. 2. A compound according to claim 1 wherein X is O. 3. A compound according to claim 1 or 2 wherein A is -(CH2)3-. 4. A compound according to claim 1,2 or 3 wherein R1 and R2 are independently hydrogen or methyl. 5. A compound according to claim 1, 2,3 or 4 wherein R3 is hydrogen and R4 is hydrogen or halo. 6. A compound according to any one of claims 1 to 5 wherein Y is O or NH. 7. A compound according to any one of claims 1 to 6 wherein Z is of sub-formula (a) and (CH2)nl is attached at a carbon atom of the azacycle. 8. A compound according to claim 7 wherein Z is N-substituted 4-piperidylmethyl. 9. N-[( 1 (3-Phenoxypropyl)piperidmyl)methylj 3,4-dihydro-2H [1,3]oxazino[3,2-a]indole-l0carboxamide or a pharmaceutically acceptable salt thereof. 10. A process for preparing the ester or amide compounds according to claim 6, which comprises reacting an appropriate X containing acid derivative with an appropriate alcohol orsmine. 11. A pharmaceutical composition comprising a compound according to any one of claims 1 to 9, and a pharmaceutically acceptable carrier. 12. A compound according to claim 1 for use as an active therapeutic substance. 13. The use of a compound according to claim 1 in the manufacture of a medicament for use as a 5-HT4 receptor antagonist 14. The use according to claim 13 for use as a 5-HT4 antagonist in the treatment or prophylaxis of gastrointestinal disorders, cardiovascular disorders and CNS disorders.

Inventors: GASTER LARAMIE MARY, WYMAN PAUL ADRIAN, GASTER, LARAMIE, MARY, WYMAN, PAUL, ADRIAN
Applicants: GASTER LARAMIE MARY, SMITHKLINE BEECHAM PLC, WYMAN PAUL ADRIAN, GASTER, LARAMIE, MARY, WYMAN, PAUL, ADRIAN
Application year: 1994
Main classification: C07D498
IPC codes: A61K31, A61P9, C07D491, C07D498, C07D513